Two-View Specimen Radiography in Assessing the Surgical Margins of Breast Carcinoma

The objective of this article was to assess whether the presence of infiltrating or intraductal carcinoma at the margins of breast excision could be detected more accurately by 2-view rather than by 1-view specimen radiography. The authors took 2-view specimen radiographs of 50 consecutive surgical specimens of breast carcinomas. The original mammograms, the margins on the specimen radiographs, on-1 versus on-2 views, and the histopathologic findings at the specimen margins were correlated. Margins for each view were categorized as involved or not involved. On histopathologic examination 12 specimens had margins involved by the tumor. Tumor at the surgical margin on single-view specimen radiography was detected in 8 cases. Tumor was detected at the surgical margin on 2-view specimen radiographs in 11 cases. All the intraductal carcinomas in association with radiographic calcifications at or close to margins were seen on 2-view radiography. On specimen radiography, greater detail and number of calcifications were seen compared with the initial mammogram. Intraductal carcinoma grows within the ductal tree in an unpredictable fashion that can be close or into the margins. Two-view specimen radiographs showed tumor at the margin of the specimen more precisely, which can be particularly useful in cases of intraductal carcinoma.